A Dozen Minutes and Stitches

A Dozen Minutes and Stitches

Lelo PHCU staff treat the young patient. {Photo credit: MSH.}Photo credit: MSH.

Accessing Health Care in Lelo, South Sudan

“Diktor! Diktor!” ("Doctor! Doctor!")

The urgent call came from several school boys who had run to the facility.

I glanced over and saw a boy about 12 years old tensely sit down in the waiting patio at Lelo Primary Health Care Unit (PHCU) in South Sudan. After a few seconds, I looked closer and noticed the blood dripping down his arm from a three-inch gouge at his left elbow.

As the health workers at the facility shuffled around obtaining the necessary means to treat their young patient, the story emerged that while playing nearby with friends, the boy fell and sliced his arm open on a broken shard of glass.

Jackson Ajor, the medical assistant in charge of the facility, worked with the woman in charge of dressing to clean the wound, numb the arm, and then begin the process of suturing the wound.

A dozen minutes and stitches later, the boy was bandaged up and provided with a gauze sling to protect his arm. As he stoically braced his arm in the aftermath of his ordeal, I couldn’t help but reflect how fortunate he was to suffer his injury so close to a health facility with skilled staff.

Lelo is a small community in Upper Nile State, near the city of Malakal. However, despite its proximity to one of the largest cities in South Sudan, it remains cut off from many of the basic services simply because of one fact: The Nile River flows between Lelo and Malakal.

The only bridge across the entire Nile in South Sudan is located in Juba, more than 400 miles to the south. Without a bridge, crossing the river is a time consuming and inconvenient process.  To travel in to Malakal town from Lelo requires walking several kilometers to the river, finding a boat, paying for transport, and hoping the boat does not run out of gas or become entangled in plants.  Once across the river reaching a health facility still requires walking or taking a boda boda (motorbike taxi) several kilometers to the nearest facility.

Fortunately for this patient, Lelo PHCU operates here and is supported by the second phase of the United States Agency for International Development (USAID)-funded Sudan Health Transformation Project (SHTP II). SHTP II, which is led by Management Sciences for Health and implemented in Malakal through local partner International Medical Corps, works closely with the State Ministry of Health to increase access and availability of health services in South Sudan. SHTP II helps to provide drugs, equipment, and staff training for more than 160 health facilities across South Sudan.

Thanks to support like this from SHTP II to Lelo PHCU, after falling and slicing his arm open, this boy from Lelo did not have to find a way across the river, which would have delayed treatment and increased the possibility of infection. Instead, within minutes (instead of hours) of falling, he reached a fully functioning health facility with capable staff, suture equipment, and medicines to prevent infections like sepsis and tetanus -- and the facility provided the treatment free of charge.

The young patient shows off his arm in a gauze sling. Photo credit: MSH

After the suturing finished, I sat next to the young patient and tried to draw out a smile by using my paltry Arabic knowledge to say encouraging and silly things. Seeing him eye my own elbow, I lifted it up, pointed to my own gauze, then back at his, saying, “Look, we are the same!”

The previous day I had my own elbow dressed at another SHTP II-supported facility, after a running accident. Observing my own matching wound, the young patient looked at me, grinned, and gave me a thumbs up.

I smiled back, reflected on the speed and efficiency of this boy’s care, and the coordination necessary to run health care smoothly, and thought yes, thumbs up, indeed.

Erin Polich is a communications consultant with the SHTP II project and is working in South Sudan. Erin is a graduate of Boston University’s School of Public Health.